Sinus pause
Also calledsinus arrest · sinus pause/arrest · sinus pause
Definition
A transient failure of sinoatrial node impulse formation (sinus arrest) producing a pause with no P wave, and therefore no QRS-T, until the sinus node or an escape focus fires. Unlike sinoatrial exit block, the pause has no fixed relationship to the underlying sinus cycle (it is not necessarily a whole-number multiple of the baseline P-P interval). The 2018 ACC/AHA/HRS bradycardia guideline counts a pause as a sinus pause when the sinus node depolarizes more than 3 seconds after the last atrial depolarization.
Clinical noteA pause over 3 s is not diagnostic on its own: pauses of 2 to 3 s have been recorded in healthy older people and long-distance runners, and pauses during sleep are relatively common.
Sources
- Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. Circulation. 2019;140(8):e382-e482. doi.org/10.1161/CIR.0000000000000628
- Mason JW, Hancock EW, Gettes LS. Recommendations for the standardization and interpretation of the electrocardiogram: Part II: electrocardiography diagnostic statement list. Circulation. 2007;115(10):1325-1332. doi.org/10.1161/CIRCULATIONAHA.106.180201
- Da Costa D, Brady WJ, Edhouse J. ABC of clinical electrocardiography: bradycardias and atrioventricular conduction block. BMJ. 2002;324(7336):535-538. doi.org/10.1136/bmj.324.7336.535
- Viljoen C, Smith R, Chin A. Reviewing the causes of electrocardiographic pauses. Cardiovasc J Afr. 2017;28(4):257-260. doi.org/10.5830/CVJA-2017-041
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.